It's the last thing a person will ever do.
As the federal government recently enacted legislation in Bill C-14 which allows physicians or nurse practitioners to provide medical assistance in dying, now those who are suffering intolerably and whose "natural death is reasonably foreseeable" may now take fate into their own hands.
Within the five health authorities in B.C. there is in place a Medical Assistance in Dying (MAiD)care coordinator, including Kirsten Thomson at Northern Health, who took part in developing the processes followed by the provincial health authorities.
To date there have been seven medically assisted deaths within the Northern Health Authority region.
When a person is considering being medically assisted in their death the first step is to go to their family physician. If the doctor is not in the position to assist, they usually would make a referral to Thomson or another physician they know would do it. Thomson has 40 doctors on the list that are willing to provide MAiD.
Within the process there are two medical opinions needed to ensure the patient meets the criteria to be eligible to be medically assisted in their death and the patient will be provided with a form to fill out to make the request and two witnesses need to sign it.
Each medical professional will review with the patient things like their diagnosis and prognosis, alternative treatments, pain control, palliative care and hospice care, and advise them of the option for the patient to change their mind at any time during the process.
There is at least 10 days between the patient's signed request and the day MAiD is provided.
Nurse practitioners are also eligible to provide the service. A nurse practitioner is a registered nurse who has additional training and has a different licence through their college that allows them to have a more extensive role in diagnosing and prescribing for patients, explained Thomson.
"The assessor meets with the patient to ensure all the eligibility criteria are met," Thomson said.
A second medical professional also completes an assessment but then will write the prescription and do the administration of the medication and that person is called the prescriber, she added.
There are two medication options in B.C. for those wish to be medically assisted in their death.
"A patient can choose between an oral medication cocktail and an intravenous regimen," Thomson said. "Both regimens contain fairly heavy sedation so generally the experience is that before anything else happens the patient is solidly sedated generally to a point of unconsciousness."
Another option to consider when making the ultimate decision is location.
"When we look at planning, it's really important, obviously, that we're involving the patient and what their wishes are," said Thomson. "We consider whether they would prefer to have it administered in their home or whether they would prefer to have it administered elsewhere."
Options include another private setting or a facility like a long term care home in which the patient is residing.
"We are happy to accommodate the preference for the patient," Thomson said.
One patient contemplated an outside setting but it was not completed, shen added.
"But we are prepared to do that," Thomson said. "At Northern Health and at all the health authorities in B.C. as we've proceeded in developing our processes for this it's been very important always that this is person and family centred, that this is very respectful of the fact that this is a person's ultimate decision about their autonomous care choices."
For more information about MAiD visit bit.ly/2ph22AC
